Forensic significance of X-ray data in the definition prescription of diaphyseal fractures: a case from expert practice

BACKGROUND: Determining the prescription of fractures is important when conducting a forensic medical examination of victims, accused persons, etc. This allows the expert to immediately determine the causal relationship of the skeletal injury found in the sub-expert with the events described in the decision on the forensic medical examination, especially in cases when the conducted examination according to medical documents may be concealed or distorted of the incidental circumstances; thus the investigating authorities need to decide on the case and establish the truth. Often, medical documents, especially in cases of a single request for medical help, do not contain enough information about the clinical picture of the fracture, with limited or missing descriptions of the local status. In such cases, one of the most important sources of information for the expert is radiography data (radiographs in electronic form or on X-ray film and computed tomograms), which the study allows the expert to conclude the mechanism of injury and the prescription of fractures. The study of literary sources on this topic did not reveal the exact criteria for determining the prescription of fractures based on the study of the X-ray examination results in the forensic aspect.

CASE PRESENTATION: The description of a case from practice was provided. In our practice, a case with fractures that did not correspond to the events of the described incident in the resolution as found by the sub-expert, and these fractures were not regarded by the surgeon as “old” and unrelated to the specified circumstances of the case. The presented radiograph examination allowed the forensic medical expert to determine the time frame of the detected fractures and establish the absence of a causal relationship of this injury with the events specified in the resolution.

CONCLUSION: The analysis of this expert case allows us to conclude the importance of examining the radiography data by the forensic medical expert to determine the description of fractures.

SIGNIFICANCE FOR FORENSIC MEDICINE: The presented case from the practice demonstrates the need for a critical approach of the forensic expert, both to the presented medical data and the information contained in the materials of the preliminary examination or criminal case, as well as the importance of an independent study of the X-ray examination results of the subject.